Individual
KEATON SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17315 ARCATA AVE, PFLUGERVILLE, TX 78660-6218
(512) 484-9161
Mailing address
17315 ARCATA AVE, PFLUGERVILLE, TX 78660-6218
(512) 484-9161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
37206
TX
1223P0221X
Pediatric Dentistry
Primary
37206
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/10/2020
Last updated
01/19/2024
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